Pain, discomfort or raw feeling of the throat, especially when swallowing.
Children less than 2 years of age usually don't know how to complain about a sore throat. A young child who refuses previously enjoyed foods or begins to cry during feedings may have a sore throat. Their symptoms are captured by the DRINKING FLUIDS, DECREASED guideline.
Cause
Most sore throats are part of a cold. Of severe sore throats, about 20% are caused by the Strep bacteria. Only these need an antibiotic.
See More Appropriate Topic (instead of this one) If
Sore throat is mild and the main symptom is croup, hoarseness or a cough. (Note: these symptoms are rarely seen with Strep.) (See CROUP or COUGH)
(To go directly to these topics, click on the links following this document.)
WHEN TO CALL YOUR DOCTOR FOR SORE THROAT
Call 911 Now (your child may need an ambulance) If
Severe difficulty breathing (struggling for each breath, making grunting noises with each breath, unable to speak or cry because of difficulty breathing)
Call Your Doctor Now (night or day) If
Your child looks or acts very sick
Difficulty breathing, but not severe
Great difficulty swallowing fluids or saliva
Fever greater than 104°F (40° C) or stiff neck
Signs of dehydration (very dry mouth, no tears with crying and no urine for more than 8 hours)
Purple spots or dots on skin
Call Your Doctor Within 24 Hours (between 9am and 4pm) If
You think your child needs an office visit or throat culture
Sore throat pain is severe
Pink rash that's widespread
Earache or sinus pain/pressure
Fever has lasted more than 3 days
Age less than 1 year old
Exposure to Strep within last 7 days
Sores present on the skin
Sore throat is the main symptom and persists more than 24 hours
Call Your Doctor During Weekday Office Hours If
Sore throat with cold/cough symptoms is present more than 3 days
You have other questions or concerns
Parent Care at Home If
Probable viral throat infection and you don't think your child needs to be seen.
HOME CARE ADVICE FOR SORE THROATS
1. Reassurance: Most sore throats are just part of a cold. The presence of a cough, hoarseness or nasal symptoms points to a cold as the cause of your child's sore throat.
2. Local Pain Relief:
Children over age 1 can sip warm chicken broth or apple juice.
Children over age 4 can suck on hard candy (e.g. butterscotch) or lollipops.
Children over age 6 can also gargle warm water with a little table salt or liquid antacid added.
3. Pain Medicine: Give acetaminophen (e.g. Tylenol) or ibuprofen for severe throat discomfort or fever greater than 102°F (39° C).
4. Soft Diet: Cold drinks and milk shakes are especially good.
(Reason: Swollen tonsils can make some foods hard to swallow.)
5. Contagiousness: Your child can return to day care or school after the fever is gone and your child feels well enough to participate in normal activities. Children with Strep throat also need to be taking an oral antibiotic for 24 hours before they can return.
6. Expected Course: Sore throats with viral illnesses usually last 3 or 4 days.
7. Call Your Doctor If
Sore throat is the main symptom AND lasts more than 24 hours
Sore throat with a cold lasts more than 3 days
Fever lasts more than 3 days
Your child becomes worse or develops any of the "Call Your Doctor" symptoms.
Lucile Packard Children's Hospital is located in Palo Alto, adjacent to Stanford University Hospital, approximately 20 miles north of San Jose, CA and 40 miles south of San Francisco.
